Symptoms depend on the ventricular rate of the tachycardia. Patients may experience palpitations, dizziness, presyncope, and syncope. Symptomatic patients diagnosed with WPW syndrome must undergo electrophysiologic studies with concomitant catheter ablation therapy of the accessory pathway. This type of treatment has a 95% success rate. 

Patients unable to undergo catheter ablation can be treated pharmacologically with flecainide and propafenone. However, these drugs are known to produce a new arrhythmia if the patient has coronary artery disease. Both drugs have been approved to treat supraventricular tachyarrhythmias, including orthodromic AV reentrant tachycardia. Second-line pharmacologic therapy includes beta-blockers to suppress orthodromic AV reentrant tachycardia. Amiodarone can also be used, which works to prolong repolarization by blocking the fast sodium and slow calcium channels to suppress ectopic beats.

Digitalis and verapamil are contraindicated in these patients, especially in the presence of atrial fibrillation. Since these drugs shorten the antegrade refractory time, they tend to suppress the normal conduction of the AV node and enhance conduction in the accessory pathway.